Comparison of Immunological and Functional Assays for Measurement of Soluble Fibrin

Dempfle, Carl-Erik; Pfitzner, S.A.; Dollman, M.; Huck, Kurt; Stehle, Gerd; Heene, D. L.

doi:10.1055/s-0038-1649796

Cited by 32 publications

(22 citation statements)

References 25 publications

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“…Although this confirms our previous results with twice the dose of LPS, our findings are at variance with clinical trials 10,22 that reported increases in soluble fibrin with similar assays. Differences in sensitivity between chromogenic assays and EIA for soluble fibrin have been described previously, particularly at soluble fibrin levels Ͻ10 g/mL, 33,34 and are a likely explanation for the discrepancies between the functional assay and the TpP assay found in our trial (Figure 2).…”

Section: Discussionsupporting

confidence: 59%

Heparin Blunts Endotoxin-Induced Coagulation Activation

et al. 1999

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Background-Lipopolysaccharide (LPS) is a major trigger of sepsis-induced disseminated intravascular coagulation (DIC) via the tissue factor (TF)/factor VIIa-dependent pathway of coagulation. Experimental endotoxemia has been used repeatedly to explore this complex pathophysiology, but little is known about the effects of clinically used anticoagulants in this setting. Therefore, we compared with placebo the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on LPS-induced coagulation. Methods and Results-In a randomized, double-blind, placebo-controlled trial, 30 healthy male volunteers received LPS 2 ng/kg IV followed by a bolus-primed continuous infusion of UFH, LMWH, or placebo. In the placebo group, activation of coagulation caused marked increases in plasma levels of prothrombin fragment F 1ϩ2 (PϽ0.01) and polymerized soluble fibrin, termed thrombus precursor protein (TpP; PϽ0.01); TF-positive monocytes doubled in response to LPS, whereas levels of activated factor VII slightly decreased and levels of TF pathway inhibitor remained unchanged. UFH and LMWH markedly decreased activation of coagulation caused by LPS, as F 1ϩ2 and TpP levels only slightly increased; TF expression on monocytes was also markedly reduced by UFH. TF pathway inhibitor values increased after either heparin infusion (PϽ0.01). Concomitantly, factor VIIa levels dropped by Ͼ50% at 50 minutes after initiation of either heparin infusion (PϽ0.01). Conclusions-This

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Section: Discussionsupporting

confidence: 59%

Heparin Blunts Endotoxin-Induced Coagulation Activation

et al. 1999

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“…This results in the formation of fibrin monomer, which will be cross‐linked to fibrin under the influence of Factor XIIIa (Dempfle et al, 1995; Dempfle, 1999). Fibrin monomer is a precise and sensitive indicator of an activated state of coagulation and is well suited for early diagnosis of venous thrombosis and DIC in humans (Dempfle et al, 1995; Vogel et al, 1996; Wada et al, 1996; Dempfle, 1999). In the horse fibrin monomer is also a very sensitive marker of an activated coagulation state, which increases before DIC (Feige et al, 1999) or jugular vein thrombosis (Stern‐Balestra, 2000) become apparent.…”

Section: Discussionmentioning

confidence: 99%

Changes in Coagulation and Markers of Fibrinolysis in Horses Undergoing Colic Surgery*

Feige¹,

Kästner²,

Dempfle

et al. 2003

Journal of Veterinary Medicine Series A

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Activation of coagulation can be frequently found in horses with colic. However, it has also been demonstrated as a sequela of surgical trauma alone in humans. The purpose of the present study was to determine changes in coagulation and fibrinolysis in horses that underwent colic surgery and to evaluate whether these changes were secondary to the colic or the surgery and wound healing. Thirty horses that underwent colic surgery with uncomplicated recovery were included. Ten horses with a Forssell's procedure served as control group with a standardized surgical trauma. Besides daily physical examinations during the observation period of 10 days, activated partial thromboplastin time (aPTT), prothrombin time and thrombin time as well as fibrin monomer (FM), D-Dimer (DD) and antithrombin (AT) III were determined. Compared with the control group the aPTT was the only standard coagulation test that was significantly prolonged before and after the event of colic surgery. After surgery, hyperfibrinogenaemia occurred in all groups. In colic groups FM and DD concentrations were within reference range at admission,and were significantly greater than in control horses after surgery. AT III activity decreased after colic surgery, but did not change in the control group. It was concluded that an activated coagulation state after colic surgery has to be expected, resulting not only from the colic disease, but also from the event of surgery.

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“…DIC is an acquired disorder that induces the exhaustion of platelets, coagulation and fibrinolytic factors and causes multiple microvascular thrombi which contribute to the development of multiple organ failure. Proinflammatory cytokines trigger the development of DIC via the tissue factor‐dependent pathway of coagulation (7).…”

Section: Introductionmentioning

confidence: 99%